Cited by 103COVID-19 and Mental HealthLong-Term Effects of COVID-19Schizophrenia research and treatment

COVID-19 and psychosis risk: real or delusional concern?

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Watson, Cameron J., Thomas, Rhys H., Solomon, Tom, Michael, Benedict Daniel, Nicholson, Timothy R., Pollak, Thomas A.·2021·Neuroscience Letters

Abstract

Historical epidemiological perspectives from past pandemics and recent neurobiological evidence link infections and psychoses, leading to concerns that COVID-19 will present a significant risk for the development of psychosis. But are these concerns justified, or mere sensationalism? In this article we review the historical associations between viral infection and the immune system more broadly in the development of psychosis, before critically evaluating the current evidence pertaining to SARS-CoV-2 and risk of psychosis as an acute or post-infectious manifestation of COVID-19. We review the 42 cases of psychosis reported in infected patients to date, and discuss the potential implications of in utero infection on subsequent neurodevelopment and psychiatric risk. Finally, in the context of the wider neurological and psychiatric manifestations of COVID-19 and our current understanding of the aetiology of psychotic disorders, we evaluate possible neurobiological and psychosocial mechanisms as well as the numerous challenges in ascribing a causal pathogenic role to the infection.

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Crossref · 10.1016/j.neulet.2020.135491

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Authors
Watson, C. J., Thomas, R. H., Solomon, T., Michael, B. D., Nicholson, T. R., & Pollak, T. A.
Affiliations
  • Queen Mary University of London (GB)
  • Royal Victoria Infirmary (GB)
  • University of Liverpool (GB)
  • King's College London (GB)
Corresponding author
Watson, Cameron J.
Venue
Neuroscience Letters
Publisher
Elsevier BV
Published
2021-01
Volume
741
Pages
135491
ISSN
0304-3940 (ISSN-L)
OpenAlex
W3098670568
Cited by
103
References
98
Citations by year
2026: 2 · 2025: 4 · 2024: 10 · 2023: 20 · 2022: 30 · 2021: 37
FWCI
8.64
Type
journal article
Language
en
Open access
Locations
  • Neuroscience Letters (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
  • Newcastle University ePrints (Newcastle Univesity)
Funders
  • National Institute for Health Research (IS-HPU-1112−10117)
  • Wellcome
  • Horizon 2020 (734584)
  • UK Research and Innovation
  • Medical Research Council
Topics
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
COVID-19 pandemic, psychosis, SARS-CoV-2, post-infectious psychosis, intrauterine infection, brain development, psychiatric risk, neurobiological mechanisms, psychosocial mechanisms, causal inference, history of pandemics, immune system
MeSH terms
COVID-19, Adolescent, Adult, Delusions, Female, Humans, Male, Middle Aged, Psychotic Disorders, Risk Factors, Young Adult

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